# BREATHITT COUNTY HOME MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942235981
- **Authorized official:** MR. TIMOTHY EUGENE SMITH (OWNER)
- **Authorized official phone:** (606) 693-0939

## Contact information

- **Practice address:** 726 HIGHWAY 15 N STE 2, JACKSON, KY 41339
- **Practice address phone:** (606) 693-0939
- **Practice address fax:** (606) 693-0938
- **Mailing address:** 726 HIGHWAY 15 N STE 2, JACKSON, KY 41339-8601
- **Mailing address phone:** (606) 693-0939
- **Mailing address fax:** (606) 693-0938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | MG0424 | KY | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 01/18/2019